Official Natesto Thread

Fortunate

Active Member
Welcome to the Natesto thread. I have used Natesto on an off for several years, but it seems to be one of the less popular TRT options here. That said, I have seen a few readers mention it, and I thought it would be good to start a dedicated thread on Natesto where people can share their thoughts and experiences.

Briefly, Natesto is a nasal gel used 2-3 times a day. It is by far the most inconvenient form of TRT. But, it has a lot of upsides, along with a few downsides. I have concluded:

UPSIDES:
  • It works quickly. Within an hour or so
  • It also wears off quickly
    • why is this an upside? If you are one who discovers you don't tolerate TRT, you don't have to live with unpleasant side effects for days (or even months with something like pellets)
  • Your system sees T in pulsatile fashion, so it does not shut down endogenous production
  • It tends not to elevate E2
  • No needles
  • No transfer to family members
  • It seems to really help with mood
    • One of the primary reasons people seek TRT is to address the psychologic aspects of low T, such as mood, libido and energy (energy may fall into more than just the psychologic category). Natesto seems to be excellent with mood, but not as good with libido
  • It tends not to elevate hematocrit
Downsides:
  • Inconvenient for some (three times a day, nasal)
  • Unpleasant application for some (nasal route, which I don't mind that much)
  • Cost
    • somehow, it is pretty inexpensive for me. I think my pharmacy uses insurance and/or coupons
  • I don't think there is very much of an anabolic benefit
    • this is hard thing to conclude, but I think it's safe to say it's less anabolic than just about any other form of TRT
  • Does not seem to boost libido
    • I am likely going back to Natesto. I will track this and report back, but I am fairly certain that it does not help libido much at all (definitely not when compared to cream)
  • Over time, rubbing your nose can cause skin irritation around the nose
    • Natesto requires brief rubbing of the nostrils to spread the medication
    • I break out easily and one of the things that can encourage a break out is skin to skin pressure. I think Natesto may cause some local skin irritation
  • I sometimes I worry that the dosing may not be consistent
    • it can be hard to apply it the same way every time
  • I wonder if nasal congestion can inhibit uptake
    • although, I did read that seasonal allergy related congestion does not alter absorption
For me, most forms of TRT help early on. Over time, TRT can become unpleasant, presumably from gradual elevation of average concentration levels and/or peak/trough levels. While I have not pinned down exactly what causes me to feel bad, possibilities included excess T, excess E2, excess DHT or some suboptimal ratio of these. The excesses cause some downstream events that translate into feeling bad.

Natesto simply does not do this. I never feel "over the top" on it. It is the gentlest form of TRT for me. On the other hand, it would be nice if it could help more with libido and body composition.

Ultimately, for me, it comes down to prioritizing. I would sacrifice some libido and body composition in order to feel mentally clear and emotionally content. But, it sure would be nice to figure out some way to "have it all".

The things I currently would like to know:
  • Is there a way to boost libido while using Natesto?
  • Empower compounds a nasal gel
    • how does it compare to Natesto?
      • easier to use?
      • cost?
    • there are two dosing options
      • does the higher dosing provide benefit over the standard dose, or is the extra T somehow superfluous?
  • @Tester has mentioned his experience with a nasal spray. After learning a bit about this, it sounds interesting, but has to be applied very frequently (more than Natesto). Does anyone else have experience with a spray?
Questions or comments about Natesto? Feel free to leave feedback, ask questions or make suggestions.
 

Cataceous

Super Moderator
...
For me, most forms of TRT help early on. Over time, TRT can become unpleasant, presumably from gradual elevation of average concentration levels and/or peak/trough levels. While I have not pinned down exactly what causes me to feel bad, possibilities included excess T, excess E2, excess DHT or some suboptimal ratio of these. The excesses cause some downstream events that translate into feeling bad.
...
Another possibility is TRT's disruption of upstream hormones: kisspeptin, GnRH, LH, FSH, progesterone, DHEA, pregenolone... I've found that "putting back" some of these makes me feel a lot closer to normal. In some cases TRT can also interfere with the adrenal and thyroid axes.

I would like to see greater awareness of Natesto and its equivalents. I think they should be the first-line treatment for hypogonadism. Conventional TRT is such a blunt instrument that at times it feels like the two steps forwards one makes in resolving symptoms are offset by at least a step backwards in the form of side effects.
 

Lucky Cat

New Member
I've used the nasal gel by Empower. It's more like a cream, very easy to apply if you do it right. The gel comes in a 3ml pen-like syringe that's about the size of a magic marker. One full rotation will give you 8 clicks, and that's what you apply to each nostril (5mg + 5gm= 10mg). One syringe lasts 10 days if you apply it 3x/day, so you need 3 syringes per month. I think I was quoted $45 for a syringe. I haven't used the Natesto gel since it's very pricey, but their dosage is pretty much equivalent- 5.5mg + 5.5mg (each nostril)= 11mg per dosage.
 

Fortunate

Active Member
Thanks, Nelson. That's actually really helpful. I clearly need to get more facile at my search capabilities!

@stx359 made mention a few years ago about being on a combination of Natesto and cream. I have a question out to him to see if he is still doing this combo. I actually did this a few years ago and had good results. I am considering it again, but am wondering if anyone else has experience with this combination? Part of the benefit of Natesto is that it preserves endogenous production, but I believe it was @Cataceous that suggested this combo defeats the purpose of maintaining endogenous production, as it would shut it down. It's a good point. On the other hand, I think it worked for me, so I am considering it again. I also don't know where my endogenous production is. I was on hCG for years (100-150 IU/day), but recently stopped (feel better off it).
 

stx359

Active Member
Thanks, Nelson. That's actually really helpful. I clearly need to get more facile at my search capabilities!

@stx359 made mention a few years ago about being on a combination of Natesto and cream. I have a question out to him to see if he is still doing this combo. I actually did this a few years ago and had good results. I am considering it again, but am wondering if anyone else has experience with this combination? Part of the benefit of Natesto is that it preserves endogenous production, but I believe it was @Cataceous that suggested this combo defeats the purpose of maintaining endogenous production, as it would shut it down. It's a good point. On the other hand, I think it worked for me, so I am considering it again. I also don't know where my endogenous production is. I was on hCG for years (100-150 IU/day), but recently stopped (feel better off it).
No I am not currently on this regimen. I even made a second attempt at it, this time in conjunction with Cataceous' HPTA restart protocol, which was successful, but the Natesto was not. My trough numbers were absurdly low, in the 200's, and even my sensitive E2 came back 14 which I don't believe to be a healthy number. Now I am on daily testosterone proprionate injections. Honestly I can't remember ever having a positive outcome from any topical testosterone application, either Natesto or cream, in several trials. It has never done a thing for me.
 

Match

Member
Parte do benefício do Natesto é que ele preserva a produção endógena, mas acredito que foi [USUÁRIO = 38109] @Cataceous [/ USUÁRIO] que sugeriu que esta combinação anula o propósito de manter a produção endógena, pois iria desligá-la. É um bom ponto. Por outro lado, acho que funcionou para mim, então estou considerando novamente. Também não sei onde está minha produção endógena. Eu usei hCG por anos (100-150 UI / dia), mas parei recentemente (me sinto melhor com isso).
I wonder if Androgel blocks endogenproduction, HPA axis, or is similar to Natesto
 

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